Basic Concept 3 units: Maximum ergonomics for your health

Several studies have shown that being a dental professional isn’t very good for your health – and especially not for your spine. The problems are caused by long periods spent in tense and twisted positions when performing dental work. When the upper body is bent forward, more pressure is applied to the intervertebral discs compared to when in an upright posture – whether sitting or standing. Given 8 hours of work per day, 5 days of the week, 48 weeks per year and approximately 36 years of employment, this adds up to 69,120 hours of unhealthy working posture.


Why do dental professionals put up with so much discomfort? A possible explanation would be the prioritization of the patient. They are the clients and they should experience a treatment that is as comfortable as possible. For many dentists, the sitting position offers the most comfort to patients. However, in this position dentists have a poor view of the tooth surfaces, especially when treating the upper jaw. The logical consequence – they twist themselves to get a better view.


In everyday life, we would automatically address the cause of our uncomfortable posture. For example, if the plate wasn’t placed in front of us when eating, we wouldn’t eat in an uncomfortable position, we’d move the plate and cutlery accordingly. The reality is that acrobatics during dental treatments are unnecessary, not only for the dentist but also for the patient. And when the dental team is relaxed, this means that the patient is also relaxed.


To achieve an ergonomic balance, the treatment area needs to be considered. Are all necessary instruments within reach, so that no rotating movements are required? Are the patients positioned in such a way that the light is parallel to the dentist’s line of vision? The treatment unit plays an important role here, and it’s very important to think carefully before making a decision to buy one. Not only does it have a high acquisition cost, but, according to the amortization tables of the Federal Tax and Revenue Office, it is used, on average, for a period of ten years.


Most dentists go for the unit they learned to use during their studies at university or during their residency. They’re used to the way it works and don’t need to make any changes to their workflow. However, it’s worth looking outside the box. Even though dental units currently available on the market might look the same, there are substantial differences when it comes to the position of the rotating instruments and the suction instruments used by the dental assistants. To understand this better, we can look to Karl Heinz Kimmel, who has developed an index scheme for workplace design and used it to distinguish between four basic concepts.

In Germany, approximately 88.2% of dentists work according to Basic Concept 1. This means that the dental unit is placed to the right of the patient chair and is moved horizontally (mobile or swivel arm). The dentist reaches right for the hose-connected instruments, forward to the sliding table and left for the cabinet. The assistance unit is placed to the left of the patient chair, and is partially or completely moved in a horizontal direction (hinged or parallel to the chair axis). The assistant reaches left for the suction cannula and the multifunction syringe, forward to the sliding table and right for the cabinet. If necessary, he/she must change the suction cannula from the left to the right hand. With this treatment concept, the dentist and assistant must engage in several rotating movements to reach for the instruments.


In Scandinavia, dentists prefer Basic Concept 3, which is used by approximately 8.7% of dentists in Germany. Here, the units for the dentist and assistant can swivel from the left side and over the patient, which ensures a relatively short reaching distance. The dentist reaches for the hose-connected instruments to the right, the assistant reaches to the left. The sliding table is located behind the patient’s head. These positions require very few stressful torsional movements of the spine during the treatment on the patient.


XO CARE’s treatment units are designed with this basic concept in mind. With the XO unit, the instrument tray is placed over the patient’s chest, so the dentist and assistant have short reaching distances and can concentrate without looking away from the oral cavity of the patient. What’s more, thanks to this treatment concept, dentists can work very well on their own. This is not only cost-efficient for the practice, but it ensures a very quiet and relaxed atmosphere for the patient. An additional advantage of XO CARE’s dental units is the easy conversion for left-handed professionals. Only the multifunction syringe and suction hose holder have to be moved from the left to the right side. The sleek design of the unit means that an ample amount of space is available on both sides.


In general, for both everyday life and the workplace, it’s recommended that you pay attention to your posture as often as possible. If you do this, postural defects will either never become a problem or will be counteracted at an early stage.



[1] Rohmert W. Mainzer J, Zipp P (1986) The dentist in the context of ergonomics – an analysis of dental working postures. Research Institute for Dental Care. Deutscher Ärzte-Verlag, Cologne


[2] Micheelis W (1984) Characteristics of dental workload: results of a questionnaire study. Deutscher Ärzte-Verlag, Cologne


[3] Wilke HJ, Neef P, Caimi M et al (1999) New in vivo measurements of pressures in the intervertebral disc in daily life. Spine (Phila Pa 1976) 24(8):755–762


[4] Depreciation tables for the “healthcare“ industry, taken from: am 12.07.2018


[5] Kimmel K (2001) Dental practice and work design. Deutscher Ärzte-Verlag, Cologne


[6] Hilger M (1999) Ergonomics in the dental professional practice – a survey. Thesis, Faculty of Medicine, Cologne.